Lu B F, Yin W J, Xu T, Li N N, Yi G L
Department of Science and Education, Wuhan Prevention and Treatment Center for Occupational Diseases, Wuhan 430015, China Hubei Provincial Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan 430070, China.
Department of Science and Education, Wuhan Prevention and Treatment Center for Occupational Diseases, Wuhan 430015, China.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2022 Oct 20;40(10):733-736. doi: 10.3760/cma.j.cn121094-20211105-00545.
To investigate the effect of low-dose X-ray ionizing radiation on thyroid function of radiation workers. From January to December 2021, a total of 1039 medical workers in some tertiary hospitals in Wuhan were selected as the survey subjects, of which 518 radiation workers were selected as the exposure group, and 521 non-radiation workers were selected as the control group. The general conditions of the two groups were collected, and 5 indicators of thyroid function were measured, including total thyroxine (TT(4)) , total triiodothyronine (TT(3)) , free triiodothyronine (FT(3)) , thyroid stimulating hormone (TSH) , and free thyroxine (FT(4)) . The annual cumulative dose of ionizing radiation exposure in the exposure group was collected. Pearson χ(2) test and independent sample test were used to compare the general conditions, 5 indicators of thyroid function and abnormal rate between the two groups. Linear regression model was used to analyze the correlation between the annual cumulative dose and 5 indicators of thyroid function in the exposure group. Binary logistic regression was used to analyze the influencing factors of thyroid dysfunction in the exposure group. The TT(4) levels of the workers in the control group and the exposure group were (7.95±1.07) μg/dl and (8.26±1.41) μg/dl, respectively, and the FT(4) levels were (16.33±2.19) pmol/L and (17.15±2.42) pmol/L, respectively, the rate of thyroid dysfunction was 4.80% (25/521) and 8.49% (44/518) , and the above differences were statistically significant (<0.05) . Linear regression analysis showed that the annual cumulative dose of the exposure group was significantly correlated with TT(4), TT(3), FT(4), and TSH (<0.05) . For every 1 mSv increase in the annual cumulative dose, TT(4) increased by 1.661 μg/dl, FT(4) increased by 1.422 pmol/L, TT(3) decreased by 0.113 ng/ml, and TSH decreased by 0.731 μIU/ml. Binary logistic regression analysis showed that the older the radiation workers, the higher the risk of thyroid dysfunction (=1.080, 95% : 1.016-1.148, =0.013) ; the greater the annual cumulative dose, the higher the risk of thyroid dysfunction (=6.400, 95%: 1.796-22.811, =0.004) . The annual cumulative dose of low-dose X-ray ionizing radiation is positively correlated with thyroid function TT(4) and FT(4) of radiation workers, and negatively correlated with TT(3) and TSH; the greater the age and annual cumulative dose, the higher the risk of thyroid dysfunction.
探讨低剂量X射线电离辐射对放射工作人员甲状腺功能的影响。选取2021年1月至12月武汉市部分三级医院的1039名医务工作者作为调查对象，其中518名放射工作人员作为暴露组，521名非放射工作人员作为对照组。收集两组的一般情况，并检测甲状腺功能的5项指标，包括总甲状腺素（TT(4)）、总三碘甲状腺原氨酸（TT(3)）、游离三碘甲状腺原氨酸（FT(3)）、促甲状腺激素（TSH）和游离甲状腺素（FT(4)）。收集暴露组的电离辐射年累积剂量。采用Pearson χ(2)检验和独立样本检验比较两组的一般情况、甲状腺功能5项指标及异常率。采用线性回归模型分析暴露组年累积剂量与甲状腺功能5项指标的相关性。采用二元logistic回归分析暴露组甲状腺功能障碍的影响因素。对照组和暴露组工作人员的TT(4)水平分别为（7.95±1.07）μg/dl和（8.26±1.41）μg/dl，FT(4)水平分别为（16.33±2.19）pmol/L和（17.15±2.42）pmol/L，甲状腺功能障碍发生率分别为4.80%（25/521）和8.49%（44/518），上述差异有统计学意义（<0.05）。线性回归分析显示，暴露组的年累积剂量与TT(4)、TT(3)、FT(4)和TSH显著相关（<0.05）。年累积剂量每增加1 mSv，TT(4)增加1.661 μg/dl，FT(4)增加1.422 pmol/L，TT(3)降低0.113 ng/ml，TSH降低0.731 μIU/ml。二元logistic回归分析显示，放射工作人员年龄越大，甲状腺功能障碍风险越高（=1.080，95%可信区间：1.016 - 1.148，=0.013）；年累积剂量越大，甲状腺功能障碍风险越高（=6.400，95%可信区间：1.796 - 22.811，=0.004）。低剂量X射线电离辐射的年累积剂量与放射工作人员的甲状腺功能TT(4)和FT(4)呈正相关，与TT(3)和TSH呈负相关；年龄和年累积剂量越大，甲状腺功能障碍风险越高。
